Survey: Pysicians reducing their hours/access

[Taco John]

Comprehensive Survey of 13,575 U.S. Physicians Points Toward Substantial Challenges

Research Commissioned by The Physicians Foundation Also Examines Physician Morale and Perspectives on Current / Future State of U.S. Healthcare System

Boston, MA, September 24, 2012— American patients are likely to experience significant and increasing challenges in accessing care if current physician practice patterns trends continue, according to a comprehensive new survey of practicing physicians. One of the largest physician surveys ever undertaken in the U.S., the research was commissioned by The Physicians Foundation, a nonprofit organization that seeks to advance the work of practicing physicians and help facilitate the delivery of healthcare to patients.

Physicians are working fewer hours, seeing fewer patients and limiting access to their practices in light of significant changes to the medical practice environment, according to the research, titled “A Survey of America’s Physicians: Practice Patterns and Perspectives.” The research estimates that if these patterns continue, 44,250 full-time-equivalent (FTE) physicians will be lost from the workforce in the next four years. The survey also found that over the next one to three years, more than 50 percent of physicians will cut back on patients seen, work part-time, switch to concierge medicine, retire, or take other steps likely to reduce patient access. In addition, should 100,000 physicians transition from practice-owner to employed status over the next four years (such as working in a hospital setting), the survey indicates that this will lead to 91 million fewer patient encounters.

“It is clear that the introduction of nearly 30 million new patients into the U.S. healthcare system through healthcare reform, added to the already growing physician shortage, will have profound implications for patient access to medical care,” said Walker Ray, M.D., vice president of The Physicians Foundation and chair of its Research Committee. “The rate of private practice physicians leaving the medical field, as well as changes in practice patterns that reduce the number of hours spent seeing and treating patients, is alarming. When these lost hours are added up, we get a much fuller and more ominous picture of the kind of access crisis that patients may soon face.”

More than half of physicians (52 percent) have limited the access of Medicare patients to their practices or are planning to do so, while one out of four physicians (26 percent) have already closed their practices altogether to Medicaid patients, the survey shows. Physicians cited rising operating costs, time constraints and diminishing reimbursement as the primary reasons why they are unable to accept additional Medicare and Medicaid patients.

The survey, fielded online from late March to early June 2012 by Merritt Hawkins for The Physicians Foundation, is based on responses from 13,575 physicians across the U.S. The overall margin of error (MOE) for the entire survey is (μ ± 0.998 percent), which indicates a “low to very low” sampling error for a survey designed to draw opinions and beliefs from a large population. Generally, an overall MOE at 99 percent confidence is considered highly trustworthy at +/- 2 percent or less, and all questions within the survey met this criterion.


Physician Morale

An overwhelming 80 percent of physicians cited “patient relationships” as the No. 1 most satisfying part of their job. Yet the survey also found an overwhelming majority of physicians, 77 percent, are pessimistic about the future of medicine. Eighty-two percent believe they have little ability to change the healthcare system.

Multiple factors were cited as driving widespread feelings of discontent among the nation’s physicians. “Liability / defensive medicine pressures” (related to potential malpractice lawsuits) was cited first, followed by “Medicare / Medicaid / government regulations,” “reimbursement issues” and “uncertainty / changes of health reform.” These issues and others cited throughout the study tend to distract or interfere with the time physicians spend with their patients, according to survey respondents.

“The level of pessimism among America’s physicians is very troubling,” said Lou Goodman, Ph.D., president of The Physicians Foundation and CEO of the Texas Medical Association. “More than 84 percent of physicians feel that the medical profession is in decline and nearly 58 percent are reluctant to recommend medicine as a career to their children. That means we need to make significant changes to ensure that we preserve the patient-physician relationship and continue to have the brightest minds going into medicine.”

Healthcare Cost Drivers

When asked about the factors driving increases in healthcare costs, “defensive medicine” was cited as the No. 1 cause for 69 percent of physicians, followed by an “aging population” (65 percent). On average, older patients visit physicians three times as often compared to younger patients. Other factors ranked included “cost of pharmaceuticals,” “advances in technology / treatment” and “social conditions.”

Additional survey findings of note include:

• Close to 92 percent of physicians are unsure where the health system will be or how they will fit into it three to five years from now
• More than 62 percent of physicians said Accountable Care Organizations (ACOs) are either unlikely to increase healthcare quality and decrease costs, or that any quality / cost gains will not be worth the effort
• Physicians are divided on the efficacy of the “medical homes” concept, and many (37.9 percent) remain uncertain about their structure and purpose
• While close to 70 percent of physicians have implemented electronic medical records (EMR), 47.4 percent have significant concerns that EMR poses a risk to patient privacy

“The 13,000 plus physicians who participated in this landmark survey, which included nearly 8,000 open-ended responses, strongly demonstrates the overwhelming desire of America’s physicians to share their perspectives and concerns about the current state of medicine,” said Tim Norbeck, CEO of The Physicians Foundation. “The accuracy, rigor and sheer scope of this survey should make it an invaluable piece of research to policy makers, healthcare providers, media and other stakeholders that truly want to understand the challenges that face America’s healthcare system.”

http://www.physiciansfoundation.org/...al-challenges/

[La literatura]

Originally Posted by Saul Good

Then the laws of free market supply/demand no longer apply. Supply will continue to drop while demand increases.

The wealthy will be able to go outside the "system", and the rest will get rationed care.

The wealthy can buy whatever they want. The ACA and our public health concerns are focused on "the rest."

[Saul Good]

Originally Posted by La literatura

The wealthy can buy whatever they want. The ACA and our public health concerns are focused on "the rest."

Hooray. This line for free bread.

[Cephalic Trauma]

Originally Posted by Saul Good

Quality
Affordability
Accessibility

Pick two

Originally Posted by Saul Good

Hooray. This line for free bread.

This. Exactly.

[Cephalic Trauma]

Originally Posted by La literatura

The wealthy can buy whatever they want. The ACA and our public health concerns are focused on "the rest."

Will you answer the question I posed earlier?

If your employer told you to take a pay cut, work longer hours, and be more productive, would you do it?

[La literatura]

Originally Posted by Saul Good

Hooray. This line for free bread.

Yeah, these right-wing scare tactics were tried two years ago when the ACA was attempting to get passed. Maybe you should start referencing death panels for grandma.

[La literatura]

Originally Posted by Saul Good

Quality
Affordability
Accessibility

Pick two

I miss the days when health care was abundant, nearly free, and top quality for everyone, said no one ever.

[La literatura]

Originally Posted by Cephalic Trauma

Will you answer the question I posed earlier?

If your employer told you to take a pay cut, work longer hours, and be more productive, would you do it?

This isn't analogous to the position physicians, "the medical staff" that is contracted out by hospitals, find themselves in.

I think we can all appreciate the fact that ACA creates a higher demand for more doctors (and nurses). You'll have to connect the dots for me about how it also makes doctors professional lives look like Thomas Hobbes' state of nature.

[Cave Johnson]

So you can't buy the best doctors available with what Medicare reimburses? So, so shocking!

[King_Chief_Fan]

Originally Posted by Cephalic Trauma

Will you answer the question I posed earlier?

If your employer told you to take a pay cut, work longer hours, and be more productive, would you do it?

wait...you mean when an appointment can't be had past 2:00 p.m. that you aren't on the golf course?

[Taco John]

Originally Posted by La literatura

Your facts are physicians conjectures. Which is great if our primary concern about public health is related to how physicians think about future events. Is that your concern? Or is a good, affordable health care system your concern?

I think it's clear that the concern is for good, affordable health care. The survey shows that physicians are planning on limiting their access, which puts the healthcare system under some strain. When a system is under strain, it's because it lacks resources to operate without strain. In this case the math is simple:

(More patients) + (Less Physicians) = (Higher Costs)

Unfortunately for your argument (and for us all), you can't pave over these concerns with happy thoughts and sunshine.

[La literatura]

Originally Posted by Taco John

I think it's clear that the concern is for good, affordable health care. The survey shows that physicians are planning on limiting their access, which puts the healthcare system under some strain. When a system is under strain, it's because it lacks resources to operate without strain. In this case the math is simple:

(More patients) + (Less Physicians) = (Higher Costs)

Unfortunately for your argument (and for us all), you can't pave over these concerns with happy thoughts and sunshine.

Having a good, affordable health care system isn't as deceptively simple as you make it out to be. There is, of course, a huge barrier between patients and physicians, and that is the health insurance industry, or medicare/medicaid. And physicians are one element of a vast industry of medical providers, which include nurses. Nobody has protected doctors better than themselves with their professional association, so we can expect regulations and standards of entering the profession to remain sufficiently high. Assuming that is so (and as I say that, I also think DOs would be on par to MDs in most states in the next few years) this may open the door for more nurses, and particularly nurse practitioners, to move ahead in the medical profession.

I'm supposed to be worried because doctors are unsure of where their place in the field is going to be in 10 years? I got other things to think about.

[loochy]

Originally Posted by King_Chief_Fan

wait...you mean when an appointment can't be had past 2:00 p.m. that you aren't on the golf course?

Are you joking? Do you even know any doctors?

[Taco John]

Originally Posted by La literatura

Having a good, affordable health care system isn't as deceptively simple as you make it out to be.

I've never made it out to be simple. I think that's the point. It's not.

The rest of your post is difficult to address, because of how much you've misinterpreted on you way to trying to make a point.

[Cephalic Trauma]

Originally Posted by La literatura

This isn't analogous to the position physicians, "the medical staff" that is contracted out by hospitals, find themselves in.

I think we can all appreciate the fact that ACA creates a higher demand for more doctors (and nurses). You'll have to connect the dots for me about how it also makes doctors professional lives look like Thomas Hobbes' state of nature.

Higher demand, less compensation. Do the math.

Dots connected.

[Taco John]

From the survey:
American patients are likely to experience significant and increasing challenges in accessing care if current physician practice patterns trends continue, according to a comprehensive new survey of practicing physicians.

Jensen17:
I got other things to think about.


Fine by me, what are you doing in this thread then?